Addressing health inequities re‐illuminated by the COVID‐19 pandemic: How can nursing respond?

Abstract

The coronavirus disease 2019 mortality rate among Black adults in the U.S. is double that of other racial and ethnic groups. The current pandemic is re‐illuminating health inequities that are pervasive in our society and reflected in our health system. This creative controversy describes critical conversations needed within nursing to acknowledge the contribution of structural racism to health equity. We recommend implementing structural competency into nursing education and prioritizing nursing research and policies focused on health equity and community‐based interventions.

Structural Competency in Health Care

“…Nursing and other health care professions are now critically tasked with examining and responding to health inequities in a different way than before. 23 , 24 Part of this response must be to recognize and incorporate understandings of factors far outside the individual locus of control that affect health, and act on dismantling such barriers.…”

Structural competency curriculum in health sciences education: a scoping review protocol

“…1(p.13) Along with social justice issues, the COVID-19 pandemic has also shed light on barriers related to meeting individuals' health care needs. 2 Although considered essential services, employees in positions such as fast food servers and grocery store attendants earn lower wages, have less access to affordable health insurance, and often live in situations that make social distancing difficult. 2 Social inequities have been critical contributors to poor health for many years.…”

“…2 Although considered essential services, employees in positions such as fast food servers and grocery store attendants earn lower wages, have less access to affordable health insurance, and often live in situations that make social distancing difficult. 2 Social inequities have been critical contributors to poor health for many years. 2 The University of Wisconsin Population Health Institute describes how modifiable determinants of health (healthy behaviors, clinical care, the physical environment, and social and economic factors) contribute to life expectancy, risk factors, and how well one may live.…”

“…2 Social inequities have been critical contributors to poor health for many years. 2 The University of Wisconsin Population Health Institute describes how modifiable determinants of health (healthy behaviors, clinical care, the physical environment, and social and economic factors) contribute to life expectancy, risk factors, and how well one may live. 3 Their model illustrates how policies and programs are at the foundation of how health is influenced by social and economic factors, health behaviors, the physical environment, and clinical care.…”

“…The term “social justice” has been used in relation to health and Braveman and Suarez-Balacazar suggest that social justice “encompasses several interrelated concepts which include equality, empowerment, fairness in their relationship between people and the government, equal opportunity and equal access to resources and goods.” 1 (p.13) Along with social justice issues, the COVID-19 pandemic has also shed light on barriers related to meeting individuals’ health care needs 2 . Although considered essential services, employees in positions such as fast food servers and grocery store attendants earn lower wages, have less access to affordable health insurance, and often live in situations that make social distancing difficult 2 . Social inequities have been critical contributors to poor health for many years 2 .…”